Clinical significance and characterization of Haemophilus influenzae type b genogroup isolates from urine samples in an adult male population

Dual deficiency of melatonin and dihydrotestosterone promotes stromal cell damage and mediates prostatitis via the cGAS-STING pathway in sleep-deprived mice

PURPOSE

Prostatitis is a highly prevalent condition that seriously affects men's physical and mental health. Although epidemiological investigations have provided evidence of a correlation between insufficient sleep and prostatitis, the pathogenesis of prostatitis remains unclear. We sought to identify the underlying mechanism involved and identify a promising therapeutic target.

METHODS

Sleep deprivation (SD) was utilized to establish a mouse model of insufficient sleep in a special device. Prostatitis was observed at different time points post-SD. The degree of prostatitis was evaluated by pathological section and behavioural tests. Using immunofluorescence, western blot, and proteomic analyses, the underlying mechanism of SD-related prostatitis was investigated, and the development and therapeutic target of prostatitis were elucidated.

RESULTS

SD, as an initial pathological trigger, resulted in a reduction in dihydrotestosterone and melatonin levels. Proteomic analysis revealed that the cGAS-STING pathway may play a significant role in inducing prostatitis. The subsequent results illustrated that the dual reduction in dihydrotestosterone and melatonin led to an accumulation of reactive oxygen species and the release of mitochondrial DNA (mt-DNA). The accumulation of mt-DNA activated the cGAS-STING pathway, which recruited inflammatory cells into the prostatic stroma through the secretion of interferon-β. Consequently, an inflammatory microenvironment was formed, ultimately promoting the development of prostatitis. Notably, mice with SD-induced prostatitis gradually recovered to a normal state within 7 days of recovery sleep. However, after being subjected to SD again, these mice tended to have a more pronounced manifestation of prostatitis within a shorter timeframe, which suggested that prostatitis is prone to relapse.

CONCLUSIONS

The cGAS-STING pathway activated by dual deficiency of dihydrotestosterone and melatonin plays a comprehensive inflammatory role in SD-related prostatitis. This research provides valuable insights into the pathogenesis, therapeutic targets, and prevention strategies of prostatitis.

Haemophilus Influenzae Epididymo-Orchitis and Bacteraemia in an Immunocompetent Patient

Background

Epididymitis is a common cause of scrotal pain in adults, with coliform bacteria being the most common isolated organisms in patients older than 35.

Case presentation

A 51-year-old healthy patient presented with scrotal pain and swelling, and was found to have epididymo-orchitis and bacteraemia caused by Haemophilus influenzae, which has not previously been reported as a cause of epididymo-orchitis and bacteraemia in immunocompetent patients.

Discussion

Diagnostic studies can help confirm the diagnosis and detect the causative pathogen. In all suspected cases, a urinalysis, urine culture and a urine or urethral swab for nucleic acid amplification tests (NAATs) for Neisseria gonorrhoeae and Chlamydia trachomatis should be performed. Colour Doppler ultrasonography often shows an enlarged thickened epididymis with increased Doppler wave pulsation in epididymitis. H. influenzae are pleomorphic gram-negative rods that commonly colonise the human respiratory tract and are associated with a number of clinical conditions. H. influenzae has been reported as a cause of epididymo-orchitis in prepubertal boys, and in few cases were associated with positive blood cultures. In adults, H. influenzae has been isolated before from urine samples or urethral swabs in patients with epididymitis or epididymo-orchitis.

Conclusion

This case highlights the possibility of H. influenzae causing epididymo-orchitis and bacteraemia in immunocompetent patients. Healthcare providers should consider H. influenzae in the differential diagnosis of epididymitis and epididymo-orchitis in both immunocompetent and immunocompromised patients.

LEARNING POINTS

H. influenzae can cause epididymo-orchitis and bacteraemia in immunocompetent patients. This has not been previously reported.H. influenzae should be considered in the differential diagnosis of epididymitis and epididymo-orchitis in both immunocompromised and immunocompetent patients.Healthcare providers should be aware of the increasing incidence of epididymitis and epididymo-orchitis caused by non-coliform bacteria in patients older than 35 years, especially in immunocompromised patients.

Assessment of the Urinary Microbiota of MSM Using Urine Culturomics Reveals a Diverse Microbial Environment

BACKGROUND

The urinary tract is not sterile and is populated by microbial communities that influence urinary health. Men who have sex with men (MSM) are understudied yet have increased risk factors for genitourinary infections. Our objective was to interrogate the composition of MSM urinary microbiota.

METHODS

Midstream urine specimens (n = 129) were collected from MSM (n = 63) and men seen for routine care (clinical cohort, n = 30). Demographics and sexual/medical history were documented. Specimens underwent culture using standard-of-care and enhanced methods designed to isolate fastidious and anaerobic microorganisms. Isolates were identified by MALDI-TOF mass spectrometry or 16S rRNA gene sequencing.

RESULTS

The MSM cohort was younger (mean (SD), 35.4 (11.26) years) compared to the clinical cohort (62.7 (15.95) years). Organism recovery was significantly increased using enhanced vs standard culture for the MSM (mean of 9.1 vs 0.6 species/sample [P < 0.001]) and clinical (7.8 vs 0.9 species/sample [P < 0.001]) cohorts. The microbial composition of MSM urine specimens was dominated by Gram-positive and anaerobic microbes and clustered distinctly from that of clinical urine specimens. Composition of microbial species recovered within the same subject was dynamic between urine specimens but more similar relative to inter-individual comparisons. Principal coordinate analysis showed no correlation between urinary microbiota composition and age, recent antibiotic use, sexually transmitted infection/HIV status, or sexual practices.

CONCLUSIONS

Enhanced culture recovered a large diversity of microbial species from MSM urine specimens, especially taxa typically associated with mucosal surfaces. These findings may increase understanding of urologic disease in MSM and improve diagnostic methods for detection of genitourinary infections.

New Bugs and New Drugs: Updates in Clinical Microbiology

BACKGROUND

The landscape of clinical microbiology laboratories is changing. As new technologies are introduced, we are better able to detect and identify pathogens and to recognize and characterize emerging antimicrobial resistance mechanisms.

CONTENT

In this review, a selected cross-section of current hot topics in clinical microbiology is discussed. These topics include (a) diagnostics for urinary tract and sexually transmitted infections; (b) phenotypic and genotypic methods of detecting carbapenem resistance and discussion of newly approved anti-infective agents for these multi-drug resistant organisms; and (c) the significance, epidemiology, and identification of the emerging pathogens Mycobacterium chimaera and Candida auris.

SUMMARY

Communication between clinical microbiologists and their clinical colleagues is imperative to convey the significance of emerging pathogens and resistance determinants, as well as the performance characteristics of new diagnostic methods. Additionally, as antimicrobial resistance is surging, it is important to comprehensively evaluate the resistance profiles of clinical isolates to facilitate antimicrobial stewardship and inform infection prevention measures. Although antimicrobial resistance is a global public health crisis, it is encouraging that new anti-infective agents are in the pipeline and being approved for use in patients.

Haemophilus Species as a Urinary Tract Pathogen

Haemophilus species, as a urinary tract pathogen, is rarely encountered. Routine urine culture pathogens are well documented to include Enterobacteriaciae, Enterococcus spp., Staphylococcus spp., Pseudomonas spp., and Candida spp. Pathogens encountered rarely in this context may include Corynebacterium ureolyticus and nonfermenting gram negative bacilli. This case study involves the finding of Haemophilus influenzae in a urine culture performed on a 4-year-old Caucasian girl and Haemophilus parinfluenzae in a 60-year-old African American man with pyelonephritis. Visualization of satellite colonies on blood agar was a key factor in finding H. influenza Awareness of the previous presence of Haemophilus spp. in a urine culture was instrumental in our finding of H. parainfluenzae 3 weeks later. These cases raise the question of how often Haemophilus spp. occur as urinary tract pathogens and under what circumstances one should actively perform cultures for them.

Bacteremic renal stone-associated urinary tract infection caused by nontypable Haemophilus influenzae: A rare invasive disease in an immunocompetent patient

Haemophilus species are known to colonize the upper respiratory tract and can cause infections. However Haemophilus influenzae has been rarely described as a cause of genitourinary tract infection. We report a 44-year-old nonimmunocompromised Japanese man with bacteremic pyelonephritis caused by a nontypable H. influenzae associated with a left ureteral calculus. The organism was isolated from both blood and urine cultures. Treatment consisted of 14 days of intravenous ceftriaxone and oral amoxicillin one after than other and insertion of a left ureteral stent. After discharge, he underwent extracorporeal shock wave lithotrity for the left ureteral calculus. He had no recrudescence of the symptoms. H. influenzae should be considered as a genitourinary pathogen among patients with certain risk factors such as anatomical or functional abnormality of genitourinary tract. Collaboration between clinicians and microbiology laboratory personnel is essential for correct identification of the organism and appropriate therapy for genitourinary tract infections due to this organism.

Draft Whole-Genome Sequence of a Haemophilus quentini Strain Isolated from an Infant in the United Kingdom

Haemophilus quentini is a rare and distinct genospecies of Haemophilus that has been suggested as a cause of neonatal bacteremia and urinary tract infections in men. We present the draft whole-genome sequence of H. quentini MP1 isolated from an infant in the United Kingdom, aiding future identification and detection of this pathogen.

Urinary Tract Infection Caused by a Capnophilic Proteus mirabilis Strain

From a urine sample from a patient with a urinary tract infection, a carbon dioxide-dependent Proteus mirabilis strain was isolated. It is important to perform urine cultures in 5% carbon dioxide and an anaerobic atmosphere if bacteria prominent in Gram stains do not grow on routine media in ambient air.